Facility Evaluation Report

On 08/04/2026 at 9:15 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Imelda Abolencia and explained the purpose of the visit. Administrator certificate is current. The facility’s fire clearance was approved for 6 non-ambulatory residents and 4 hospice waivers.

LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 4 total bedrooms of which 2 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms is adequate for the comfort and safety of the residents. The hot water temperature in the resident’s shared bathroom was measured at 107 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents.

Smoke detectors and carbon monoxide detectors were in operating condition during visit. Fire extinguisher was last serviced on 04/08/2026. First aid kit was observed to be complete. Fire drill was last conducted on 05/09/2026. At 9:30 AM, LPA reviewed 2 residents records. At 9:37 AM, LPA reviewed 2 staff records and 2 of 2 have current first aid training and associated with the facility. At 9:55 AM, LPA reviewed 2 of 2 samples of residents’ medications.

No deficiencies cited during visit. Exit interview conducted with Administrator and a copy of this report provided.